儿童饮食行为与中枢性性早熟的病例对照研究

陈雪; 安文花; 熊兆英; 樊怡薇; 刘洪秀; 李瑞珍

doi:10.16835/j.cnki.1000-9817.2024345

儿童饮食行为与中枢性性早熟的病例对照研究

doi: 10.16835/j.cnki.1000-9817.2024345

陈雪^{1, 2},
安文花³,
熊兆英³,
樊怡薇^{1, 3},
刘洪秀³,
李瑞珍^2, ,

1.
武汉科技大学医学部医学院，湖北 430081
2.
华中科技大学同济医学院附属武汉儿童医院(武汉市保健院)
3.
华中科技大学同济医学院公共卫生学院

基金项目:

国家自然科学基金项目 22236001

详细信息

作者简介:
陈雪(1999-), 女, 湖北恩施人, 在读硕士, 主要研究方向为儿童保健

通讯作者:
李瑞珍, E-mail: dr_lrz@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R155.1 R585
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- 被引次数: 0
出版历程
- 收稿日期: 2024-07-22
- 修回日期: 2024-09-13
- 网络出版日期: 2024-12-10
- 刊出日期: 2024-11-15

A case-control study of dietary behavior and central precocious puberty among children

CHEN Xue^{1, 2},
AN Wenhua³,
XIONG Zhaoying³,
FAN Yiwei^{1, 3},
LIU Hongxiu³,
LI Ruizhen^{2
, ,}

1.
School of Medicine, Wuhan University of Science and Technology, Wuhan (430081), Hubei Province, China

摘要

摘要: 目的探索武汉市儿童饮食行为、饮食频率与中枢性性早熟(CPP)之间的关系，为阐明导致儿童性早熟可能的相关饮食因素提供科学依据。方法 2023年2—12月在武汉儿童医院收集100例CPP儿童与100例健康儿童进行病例对照研究。采用问卷调查及访谈方式收集儿童及其父母社会人口学信息、儿童生活方式、近半年内儿童饮食行为及饮食频率等，采用条件Logistic回归模型分析儿童饮食行为以及饮食频率与CPP之间的关系。结果基线调查未发现情绪性饮食、限制性饮食、外部性饮食3种饮食行为与儿童CPP存在关联(P值均>0.05)。在儿童饮食频率与CPP的关联性分析中发现，每周食用红肉＞5次(OR=1.93，95%CI=1.01~3.68)、每月饮用碳酸饮料≥4次(OR=2.70，95%CI=1.03~7.08)、每月饮用果汁类含糖饮料≥4次(OR=2.31，95%CI=1.02~5.25)、进行营养品补充(OR=2.77，95%CI=1.47~5.22)的儿童罹患CPP的风险更高，而每月食用坚果≥4次(OR=0.21，95%CI=0.08~0.57)的儿童罹患CPP的风险较低(P值均＜0.05)。结论食用较多的红肉、高频次的饮用碳酸饮料和果汁类含糖饮料以及进行营养品补充可能是儿童发生CPP的促进因素，而经常食用坚果儿童发生CPP的概率较低。
- 饮食习惯 /
- 青春期，早熟 /
- 病例对照研究 /
- 回归分析 /
- 儿童
Abstract: Objective To explore the relationship between dietary behavior, dietary frequency and central precocious puberty (CPP) among children in Wuhan, so as to provide a scientific basis for elucidating the possible and related dietary factors leading to precocious puberty. Methods From February to December 2023, 100 children with CPP and 100 healthy children were collected in Wuhan Children's Hospital for a case-control study. Questionnaires and interviews were used to collect demographic information, child lifestyle, as well as dietary behavior and dietary frequency in the past six months. Conditional Logistic regression model was used to analyze the relationship of children's dietary behavior and dietary frequency with CPP. Results No associations were found between three dietary behavior, including emotional eating, restrictive eating, and external eating, with CPP at baseline (P>0.05). In the association analysis of dietary frequency and CPP, the risk of CPP was higher in those who consumed red meat >5 times/week (OR=1.93, 95%CI=1.01-3.68), carbonated beverages ≥4 times/month (OR=2.70, 95%CI=1.03-7.08), fruit juices ≥4 times/month (OR=2.31, 95%CI=1.02-5.25), and nutritional supplementation (OR=2.77, 95%CI=1.47-5.22), whereas the risk of CPP was lower in those who consumed nuts ≥4 times/month (OR=0.21, 95%CI=0.08-0.57) (P < 0.05). Conclusion Consumption of higher amounts of red meat, high frequency of carbonated and juice-based sugary drinks, and nutrient supplementation may be contributing factors to the development of CPP, whereas regular consumption of nuts is less likely to be associated with the development of CPP.
- Food habits /
- Puberty, precocious /
- Case-control Studies /
- Regression analysis /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 CPP组与对照组基本特征及饮食频率比较

Table 1. Comparison of the basic characteristics and dietary frequency between the CPP group and the control group

变量	选项	对照组(n=100)	CPP组(n=100)	χ²值	变量	选项	对照组(n=100)	CPP组(n=100)	χ²值
性别	男	19(19.0)	19(19.0)	0.00	低出生体重儿	是	11(11.0)	9(9.0)	0.22
	女	81(81.0)	81(81.0)			否	89(89.0)	90(90.0)
家庭年总收入/万元	≤5	22(22.0)	14(14.0)	5.31	早产儿	是	10(10.0)	9(9.0)	0.58
	>5~20	66(66.0)	63(63.0)			否	90(90.0)	91(91.0)
	＞20	12(12.0)	23(23.0)		母乳喂养情况/月	≤6	38(38.0)	33(33.0)	0.55
母亲文化程度	初中及以下	37(37.0)	15(15.0)	22.65^**		＞6	62(62.0)	67(67.0)
	高中/中专/技校	39(39.0)	30(30.0)		父母性早熟史	否	81(81.0)	67(67.0)	6.38^*
	大学及以上	24(24.0)	55(55.0)			是	0	3(3.0)
母亲月经初潮年龄/岁	≤13	68(68.0)	75(75.0)	1.20		不知道	19(19.0)	30(30.0)
	＞13	32(32.0)	25(25.0)		每周食用红肉频次	≤5	78(78.0)	65(65.0)	4.15
儿童开灯睡觉情况	无	71(71.0)	57(57.0)	4.25		＞5	22(22.0)	35(35.0)
	有	29(29.0)	43(43.0)		每周食用粗粮频次	≤5	67(67.0)	61(61.0)	0.78
儿童目前睡眠环境	与家长同室	65(65.0)	60(60.0)	4.50		＞5	33(33.0)	39(39.0)
	与兄弟姐妹同室	11(11.0)	5(5.0)		每月食用鱼贝类频次	≤1	94(94.0)	96(96.0)	0.42
	自己单独一室	24(24.0)	35(35.0)			＞1	6(6.0)	4(4.0)
儿童性教育普及	几乎不	20(20.0)	13(13.0)	2.91	每月食用油炸食品频次	≤1	96(96.0)	97(97.0)	0.15
情况	偶尔	73(73.0)	83(83.0)			＞1	4(4.0)	3(3.0)
	经常	7(7.0)	4(4.0)		每月饮用碳酸饮料频次	≤1	41(41.0)	40(40.0)	7.29^*
儿童接触化妆品	几乎不	67(67.0)	58(58.0)	1.77		2~3	53(53.0)	42(42.0)
情况	偶尔	29(29.0)	37(37.0)			≥4	6(6.0)	18(18.0)
	经常	4(4.0)	5(5.0)		每月饮用果汁类含糖	≤1	37(37.0)	36(36.0)	8.54^*
儿童每周被动吸烟情况/次	0	43(43.0)	44(44.0)	1.08	饮料频次	2~3	49(49.0)	34(34.0)
	1~3	49(49.0)	44(44.0)			≥4	14(14.0)	30(30.0)
	≥4	8(8.0)	12(12.0)		每月食用甜食频次	≤1	42(42.0)	38(38.0)	3.70
儿童户外活动时间/(h·d^-1)	≤1	24(24.0)	27(27.0)	0.51		2~3	50(50.0)	45(45.0)
	>1~2	55(55.0)	50(50.0)			≥4	8(8.0)	17(17.0)
	＞2	21(21.0)	23(23.0)		每月食用坚果频次	≤1	53(53.0)	67(67.0)	13.51^**
儿童工作日接触电子屏幕	是	67(67.0)	85(85.0)	8.88^**		2~3	24(24.0)	28(28.0)
	否	33(33.0)	15(15.0)			≥4	23(23.0)	5(5.0)
儿童周末接触电子屏幕	是	90(90.0)	93(93.0)	0.58	营养品补充	是	57(57.0)	80(80.0)	12.56^**
	否	10(10.0)	7(7.0)			否	43(43.0)	20(20.0)
注：()内数字为构成比/%；^P < 0.05，^*P < 0.01。

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表 2 儿童饮食行为评分与中枢性性早熟关联的Logistic回归分析[OR值(95% CI)，n=200]

Table 2. Logistic regression analysis of dietary behavior score and central precocious puberty among children[OR(95% CI), n=200]

饮食行为	分组	模型1	模型2	模型3
情绪性饮食	低分组	1.00	1.00	1.00
	中分组	1.00(0.35~2.85)	0.89(0.32~2.67)	1.37(0.40~4.75)
	高分组	1.00(0.06~15.99)	0.84(0.05~14.00)	2.11(0.11~39.05)
限制性饮食	低分组	1.00	1.00	1.00
	中分组	1.16(0.65~2.06)	1.11(0.61~1.98)	1.28(0.64~2.56)
	高分组	1.48(0.48~4.61)	1.33(0.44~4.60)	1.34(0.31~5.73)
外部性饮食	低分组	1.00	1.00	1.00
	中分组	0.88(0.29~2.65)	0.90(0.27~2.58)	0.94(0.25~3.60)
	高分组	1.26(0.45~3.52)	1.32(0.41~3.42)	1.04(0.29~3.67)
注：模型1为未调整结果；模型2为饮食行为评分相互调整的结果；模型3为基线与饮食行为评分相互调整，其中基线包括儿童工作日接触电子屏幕情况、母亲文化程度；P值均＞0.05。

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表 3 儿童饮食频率与中枢性性早熟关联的Logistic回归分析[OR值(95% CI)，n=200]

Table 3. ogistic regression analysis of dietary frequency and central precocious puberty in children [OR(95% CI), n=200]

自变量	选项	模型1	模型2	模型3
每周食用红肉频次	≤5	1.00	1.00	1.00
	＞5	1.93(1.01~3.68)^*	1.24(0.52~2.92)	1.20(0.42~3.41)
每周食用粗粮频次	≤5	1.00	1.00	1.00
	＞5	1.27(0.73~2.23)	1.25(0.58~2.69)	1.12(0.47~2.66)
每月食用鱼贝类频次	≤1	1.00	1.00	1.00
	＞1	0.60(0.14~2.51)	1.00(0.17~5.72)	2.42(0.29~19.88)
每月食用油炸食品频次	≤1	1.00	1.00	1.00
	＞1	0.75(0.17~3.35)	0.75(0.11~5.20)	0.72(0.06~8.30)
每月饮用碳酸饮料频次	≤1	1.00	1.00	1.00
	2~3	0.80(0.45~1.44)	0.64(0.29~1.39)	0.74(0.31~1.78)
	≥4	2.70(1.03~7.08)^*	1.19 (0.32~4.40)	2.06(0.45~9.48)
每月饮用果汁类含糖	≤1	1.00	1.00	1.00
饮料频次	2~3	0.70(0.35~1.31)	0.95(0.42~2.17)	1.06(0.42~2.66)
	≥4	2.31(1.02~5.25)^*	3.04(1.03~8.97)^*	2.15(0.65~7.14)
每月食用甜食频次	≤1	1.00	1.00	1.00
	2~3	1.01(0.53~1.91)	1.00(0.41~2.44)	1.14(0.38~3.39)
	≥4	2.30(0.88~5.99)	2.37(0.67~8.42)	1.31(0.26~6.56)
每月食用坚果频次	≤1	1.00	1.00	1.00
	2~3	0.91(0.47~1.73)	1.17(0.52~2.64)	0.76(0.30~1.99)
	≥4	0.21(0.08~0.57)^**	0.18(0.06~0.61)^**	0.15(0.04~0.62)^**
营养品补充	否	1.00	1.00	1.00
	是	2.77(1.47~5.22)^**	3.50(1.54~7.93)^**	3.70(1.53~8.99)^**
注：模型1为未调整结果；模型2为饮食频率相互调整的结果；模型3为基线与饮食频率相互调整，其中基线包括儿童工作日接触电子屏幕情况、母亲文化程度；^P < 0.05，^*P < 0.01。

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